Not what acne drug but how much you take

Documentary

I’ve just seen a BBC programme about a boy who ended his life because of depression, which was suspected to be linked to the medication he was taking for acne.

Before each new batch, I went to see the dermatologist, got a prescription, went to hospital for a blood test and then took home the pills. But no one asked me how I was.

When I was 21, after trying various different approaches, my mother organised for me to take Roaccutane to get rid of the rather persistent spots I had. I remember spending quite a long time with a cover-up stick attending to the potato patch over my left eye-brow before going to my 21st birthday party. And the little bastards hurt too.

Roaccutane

After seeing my local G.P. I was sent to see a Dr Peter Copeman on Upper Sloane Street. Each visit was paying him more than I was living on for a week and yet he dismissed all my questions about side-effects and wrote out the next prescription. He gave me the standard warnings on my first visit, but after that he didn’t give me any advice or reassurance about my hair or other discomforts.

In a Sunday weekend newspaper supplement, I read an interview with Rob Brydon who revealed that his pock-marked skin was what was left after a course of Roaccutane.

Lucky escape

Each prescription would give you a month’s supply.

Before each course of pills was dispensed, I had to go to the hospital for a blood test. It seemed weird that all these checks were made, but none of my questions were answered. Having been warned about the drying up process, advised to not do too much physical activity and told it was important not to get pregnant, the dermatologist I had to see each time I got a new prescription did not monitor me at all and airily dismissed any concerns I raised.

Because of this, I questioned going to see him and asked for my prescription to be sent by mail. It didn’t sit quite right with me that I was told I needed to have an appointment before getting the prescription. Why? Why on earth see someone just so they get paid for seeing me, when they don’t DO or check anything. He didn’t ask me any questions. He was like ‘OK, hello, thanks for coming in. I’ll get your prescription.’

Spots Gone

My spots went after the 2nd or 3rd batch. I was told I was less than half way through the treatment. There seemed no point going to see Dr Copeman as he wasn’t the slightest bit interested in my progress, just in his pay, so I got the secretaries to send me the prescription by post.

They did. I went to the hospital, had my blood test, got my pills and never took them. I had very dry skin and hair, which had got unattractively frizzy and took years to regain its oiliness. Periods were painful. I was sick of not taking exercise and my spots had gone. Why did I need to take more pills? Against strong advice (based on what?) I simply stopped taking the pills. I considered giving them to someone else, but thought that was too risky. Eventually I threw them away. I’ve not had acne since. Barely a few spots, so why did I need to take this pill for 6 months and not just till the acne had stopped returning?

This is a professional and a human failing. I just watched Gemma Cairney’s investigation on the BBC about Raoccutane, in the wake of two sad suicides or deaths of John and Jesse, and some fundamental questions were not even touched upon. Gemma did a good job but we’re not getting to the heart of the matter.

Monitor!

Humans put in a position to monitor must monitor. if a drug is even fleetingly considered to cause emotional turbulence, sexual dysfunction or other side effects, a suitable medical professional needs to be in charge of the patient to see how they are doing.

Here are my recommendations if you or a loved one has acne and are considering taking Roaccutane:

1. Just read Inconvenient People by Sarah Wise to see how biased and defensive and blinkered different professionals can be to suit their own agenda and income. Never take them on their word. Always question them. Find out what psychological support they will give if someone is taking Roaccutane. Is their head in the sand or are they going to put a patient before their ego and ensure they are MONITORING their progress and will consider that some people will be effected by the drug.

2. To find professionals who will mentally prepare a new patient at the start for possible side effects and lay out the ways in which they will listen and support the patient as if the patient actually does know their own mind and body better than another person, even one with a PHD.

3. For the course of pills to end when acne stops returning. If the patient is given enough correct and reliable information about acne, they will be the best judge for when they think the treatment should stop. Curing acne is the point here, not someone earning money.

4. Don’t take Roaccutane unless you trust and can talk to the dermatologist prescribing it.

Facial

Ten years after my Roaccutane treatment, I began to read about cases of depression and suicide in the press. I had felt ‘a bit funny’ while taking the drugs and hated the dryness. it was hard to know if I was depressed as it was a sad part of my life when my Mum died. Also, the bloody medical professionals did that English thing of Simply-Not-Mentioning any possible side effects to the psyche so I didn’t think about it. But I still instinctively stopped less than half way through the treatment, when my spots had dried up.

I went for a facial in North London and the topic of acne came up. I couldn’t remember the name of the renegade dermatologist Mr I-don’t-care-a-fuck-about-making-a-difference-so-long-as-I-get-paid in Upper Sloane Street. The beauty salon lady said ‘oh I’ve heard about this before. Dr Peter Copeman.’

The point of this tale: If you are a medical professional prescribing young people Roaccutane, flipping well look after them, even if this means that you don’t bloody know everything. It’s not about you, it’s about your patient.

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